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71.
Donald G. Klepser Michael E. Klepser Jaclyn K. Smith Allison M. Dering-Anderson Maggie Nelson Lauren E. Pohren 《Research in social & administrative pharmacy》2018,14(4):356-359
Background
One way to reduce the complications and costs of influenza like illness and pharyngitis is to improve access to testing and treatment in early stages of infection. Pharmacy-based screening and treatment of group A streptococcus (GAS) infection and influenza has the potential to improve patient care and population health.Objective
To improve patient care and population health, the objective of this retrospective study was to assess if a previously validated service model could be implemented by pharmacy chains without mandated standardization.Methods
Researchers utilized a certificate program to provide initial training to pharmacists and shared templates from previous validated models. Pharmacy companies were responsible for navigation of all implementation within their company. Researchers analyzed the de-identified data from patients seeking point-of-care testing from the participating pharmacies.Results
Participating pharmacies reported 661 visits for adult (age 18 and over) patients tested for influenza for GAS pharyngitis. For the GAS patients, 91 (16.9%) tested positive. For the Influenza patients, 22.9% tested positive and 64 (77.1%) testing negative. Access to care was improved as patients presented to the visit outside normal clinic hours for 38% of the pharmacy visits, and 53.7% did not have a primary care provider.Conclusion
A collaborative care model for managing patients with symptoms consistent with influenza or group A streptococcus can be successfully implemented, and improve access to care outside of normal clinic hours and for those without a regular primary care provider. 相似文献72.
Jo Albin-Clark Ian Shirley Maggie Webster Clare Woolhouse 《Early child development and care》2018,188(2):88-101
The dyadic nature of the teacher–child relationship is recognized as a significant factor in young children’s learning experiences. However understandings about how teachers’ own personal and professional identities and experiences influence their construction of teacher–child relationships are under researched. This article extends upon earlier research by exploring the concept of a networked dimension of teachers’ personal relationships and how they inform their perceptions of their relationships with children within a dynamic system. Through the interpretation of four teachers’ life history narratives and utilizing the lens of development systems theory, we present original insights regarding how they understand their personal and professional relationships with children. We illuminate how teachers’ lives are open, networked and overlapping in nature and that there are implications for teachers’ initial education and professional development. 相似文献
73.
Ensenyat-Mendez Miquel Rnger Dennis Orozco Javier I. J. Le Julie Baker Jennifer L. Weidhaas Joanne Marzese Diego M. DiNome Maggie L. 《Annals of surgical oncology》2022,29(8):4716-4724
Annals of Surgical Oncology - Breast cancer patients with clinically positive nodes who undergo upfront surgery are often recommended for axillary lymph node dissection (ALND), yet more than half... 相似文献
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Shubha Ananthakrishnan Nigar Sekercioglu Rosilene M. Elias Joseph Kim Dimitrios Oreopoulos Maggie Chu Joanne M. Bargman 《International urology and nephrology》2014,46(1):183-189
Background
The incidence of obesity is increasing both in the general population and in incident dialysis patients. While there is evidence that being overweight is associated with good outcomes in hemodialysis, the evidence in peritoneal dialysis (PD) patients is not very clear. We studied a modern cohort of PD patients to examine outcomes in large patients.Methods
Forty-three patients who started PD, who weighed more than 90 kg at dialysis initiation, between January/2000 and June/2010 were matched with 43 control patients who weighed less than 90 kg. Detailed review of the charts was undertaken.Results
The mean weight and body mass index of the wt < 90 kg group were 69.3 ± 11.3 kg and 25.0 ± 3.9 kg/m2. The number of peritonitis episodes per year was 0.33 ± 0.6 (wt < 90 kg) and 0.82 ± 1.7 (wt ≥ 90 kg) (p = 0.26). The median time to first peritonitis showed a trend toward earlier peritonitis in larger patients [9.5 (4.3, 27) months in wt ≥ 90 kg, 19.1(7.9, 30.8) months in wt < 90 kg] but did not reach statistical significance (p = 0.12). Surprisingly, hernias and leaks were more common in the weight <90 kg group (44 vs. 18.6 % p = 0.02). There was no difference in total number of hospitalizations or the number of days hospitalized. Kaplan–Meier analysis of survival on PD showed no differences between the two groups (logrank p = 0.99). Cox regression analysis using age, race, cause of ESRD due to diabetes and Charlson comorbidity index as the covariates did not show weight to be associated with survival on PD.Conclusions
Large patients tend to do just as well on PD, with survival on PD being no different compared to individuals with lower weight and body mass index. 相似文献76.
Lirong Cao Shi Zhao Jingzhi Lou Hong Zheng Renee W. Y. Chan Marc K. C. Chong Zigui Chen Paul K. S. Chan Benny C. Y. Zee Maggie H. Wang 《Viruses》2021,13(4)
Assessment of influenza vaccine effectiveness (VE) and identification of relevant influencing factors are the current priorities for optimizing vaccines to reduce the impacts of influenza. To date, how the difference between epidemic strains and vaccine strains at genetic scale affects age-specific vaccine performance remains ambiguous. This study investigated the association between genetic mismatch on hemagglutinin and neuraminidase genes and A(H1N1)pdm09 VE in different age groups with a novel computational approach. We found significant linear relationships between VE and genetic mismatch in children, young adults, and middle-aged adults. In the children’s group, each 3-key amino acid mutation was associated with an average of 10% decrease in vaccine effectiveness in a given epidemic season, and genetic mismatch exerted no influence on VE for the elderly group. We demonstrated that present vaccines were most effective for children, while protection for the elderly was reduced and indifferent to vaccine component updates. Modeling such relationships is practical to inform timely evaluation of VE in different groups of populations during mass vaccination and may inform age-specific vaccination regimens. 相似文献
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79.
Vikas Aggarwal Maggie A. Stanislawski Thomas M. Maddox Brahmajee K. Nallamothu Gary Grunwald Jill C. Adams P. Michael Ho Sunil V. Rao Ivan P. Casserly John S. Rumsfeld Emmanouil S. Brilakis Thomas T. Tsai 《Journal of the American College of Cardiology》2014
Background
Stenosis of saphenous vein grafts (SVGs) after coronary artery bypass grafting (CABG) is common and often requires percutaneous coronary interventions (PCI) for treatment. However, data for the effectiveness of drug-eluting stents (DES) versus bare-metal stents (BMS) in SVG-PCI are unclear.Objectives
This study sought to examine the association between DES versus BMS used during SVG PCI and clinical outcomes in the national Veterans Affairs integrated healthcare system.Methods
We studied a national cohort of 2,471 post-CABG veterans undergoing SVG-PCI between 2008 and 2011 at all Veterans Affairs hospitals and compared clinical outcomes of between those receiving DES and BMS. Clinical outcomes included procedural complications, myocardial infarction (MI), and all-cause mortality. Comparisons were made in a propensity-matched cohort using Cox proportional hazards regression models.Results
DES were used in 1,549 SVG-PCI patients (63%) and the use of DES increased progressively with each calendar year (50% in 2008 to 69% in 2011). Incidence of procedural complications was low and comparable in both groups (2.8% among BMS vs. 2.3% among DES patients; p = 0.54). During long-term (>2 years) follow-up, use of DES was associated with lower mortality than BMS (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.57 to 0.89) and similar rates of MI (HR: 0.94; 95% CI: 0.71 to 1.24) in the propensity-matched cohort.Conclusions
In a national cohort of veterans, we observed widespread and increasing use of DES during SVG-PCI. In long-term follow-up, compared with BMS, DES use was safe and effective in SVG-PCI patients. 相似文献80.
Amanda M. Midboe A. Rani Elwy Janet M. Durfee Allen L. Gifford Vera Yakovchenko Richard A. Martinello David Ross Maggie Czarnogorski Matthew B. Goetz Steven M. Asch 《Journal of general internal medicine》2014,29(4):831-834
We are in a new era of partner-based implementation research, and we need clear strategies for how to navigate this new era. Drawing on principles from community-based participatory research, the Clinical Public Health group of the Department of Veterans Affairs and the HIV/Hepatitis Quality Enhancement Research Initiative (HHQUERI) forged a longstanding partnership that has improved the care of Veterans with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus. An exemplar HIV testing project epitomizes this partnership and is discussed in terms of the lessons learned as a result of our high level of collaboration around design, analysis, implementation, and dissemination across projects over the past several years. Lessons learned through this partnered testing program involve respecting different time horizons among the partners, identifying relevant research questions for both parties, designing flexible studies, engaging all partners throughout the research, and placing an emphasis on relationship building at all times. These lessons and strategies can benefit others conducting partner-based research both within the Veterans Health Administration (VA) and in other integrated healthcare systems. 相似文献